Case series of calcaneal Osteomyelitis in patients with Melioidosis.

Background: Melioidosis is an emerging infectious disease caused by the Gram-negative bacterium Burkholderia pseudomallei, which can lead to a range of clinical manifestations including acute septicaemia and chronic localized infections. Osteomyelitis is an uncommon but well-recognized complication of melioidosis, with the calcaneus being a relatively rare site of involvement. Case Description: The authors present a case series of three patients with calcaneal osteomyelitis caused by Burkholderia pseudomallei, infection. All three patients presented with non-specific symptoms like fever and weight loss, followed by localized ankle/foot pain and swelling. Diagnosis was made based on imaging findings (radiographs and MRI) and isolation of Burkholderia pseudomallei, from blood or pus cultures. Treatment involved a combination of initial intravenous antibiotic therapy (meropenem or ceftazidime) for 4-6 weeks, followed by oral trimethoprimsulfamethoxazole for 6 months. One patient required surgical drainage of a plantar abscess. All patients had a favorable clinical outcome with a resolution of osteomyelitis on follow-up imaging. Conclusion: Calcaneal osteomyelitis is a rare but potentially serious complication of melioidosis. Early recognition and prompt initiation of appropriate antibiotic therapy are crucial for favorable outcomes. Clinicians should maintain a high index of suspicion for osteomyelitis in patients with melioidosis, especially in patients from Endemic areas as well as in patients with risk factors like diabetes. Close follow-up and monitoring for potential relapse or reactivation are essential, particularly in immunocompromised individuals. [ABSTRACT FROM AUTHOR]